Saturday, November 19, 2016

Words Fail

I just do not know what to say when I read of the genuine and legitimate panic in places like rural Kentucky over what their governor and the incoming Trump Administration may do to the Medicaid programs on which they depend (from NPR, with a h/t to Alert Tweeter Charlie Pierce):

In Depressed Rural Kentucky, Worries Mount Over Medicaid Cutbacks

In a state as cash-strapped as Kentucky, the increased expenses ahead for Medicaid will be significant in Bevin's view — $1.2 billion from 2017 to 2021, according to the waiver request he's made to the Obama administration to change how Medicaid works in his state.

Trump's unexpected victory may help Bevin's chances of winning approval. Before the election, many analysts expected federal officials to reject the governor's plan by the end of the year on the grounds that it would roll back gains in expected coverage.

A Trump administration could decide the matter differently, said Emily Beauregard, executive director of Kentucky Voice for Health, an advocacy group that opposes most waiver changes because they could reduce access to care.

"I think it's much more likely that a waiver could be approved under the Trump administration," she said. "On the other hand, I wonder if the waiver will be a moot point under a Trump administration, assuming that major pieces of the [Affordable Care Act] are repealed."

Lockaby is watching with alarm: "I am worried to death about it."

Life already is hard in her part of Kentucky's coal country, where once-dependable mining jobs are mostly gone.

In Clay County where Lockaby lives, 38 percent of the population live in poverty. A fifth of the residents are disabled. Life expectancy is eight years below the nation's average.

Clay's location places it inside an area familiar to public health specialists as the South's diabetes and stroke belt. It's also in the so-called "Coronary Valley" encompassing the 10-state Ohio/Mississippi valley region.

About 60 percent of Clay County's 21,000 residents are covered by Medicaid, up from about a third before the expansion. The counties uninsured rate for nonelderly adults has fallen from 29 percent to 10 percent...

And then I read that Republican Matt Bevin carried Clay County in 2015 with 71.1% of the vote, and Donald Trump carried Clay County in 2016 with 89.6% of the vote.

As someone whose family's insurance situation hovers between precarious and disaster and who has finally found a little momentary peace of mind thanks to the Affordable Care Act and a wife who can indefatigably navigate the mightiest soul-killing bureaucracies for weeks on end (I am not kidding), believe me when I say that I really want to help these people.  I am just, for the moment, completely out of ideas as to how to get them to stop voting for people who hurt them.  

However, I am absolutely certain that some day very soon, the greatest minds of the Beltway punditocracy are finally going to notice the unfolding health care disaster out here in flyover country, after which they will collectively climb up into a very high dudgeon to blame Both Sides for the failure.


Mike Lumish said...

Being myself a rural white guy, with family all over the rural white guy parts of this continent, my fundamental problem with all this squawking about rural white guys and their alleged abandonment by the Democratic Party is the historical fact that the rural white guys could not run away fast enough from the Democratic Party in the aftermath of the Civil Rights Era.

On top of which, the entire "Industrialized World" - not just the United States - has been deindustrializing since the late sixties. With the rise of global communications and cheap containerized shipping, everyone has dumped manufacturing on the free labor countries and the boom in automation has soaked up the rest of the jobs.

As the crowning indignity to this rural white guy, whose family has been farming in the midwest since 1840, the family farm was destroyed as a foundational economic and cultural unit by a series of deliberate policies undertaken BY THE REPUBLICANS in the seventies and eighties - to achieve rationalizion of the farming sector, knowing and accepting that people and communities would be devastated.

And the Democrats get the blame, somehow.

I have talked myself blue in the face, trying to explain this, and all I get is "it's those city folk, they hate us." That and abortion: doesn't matter that Uncle George blew his brains out with a shotgun when he lost the farm, at least his daughter couldn't get an abortion when her marriage failed.

So I don't know what I can say or do different from what I have already done.

Becky said...

I live near Kentucky. You can't imagine how much people around here hate Obama. They HATE Obamacare too but they love their Kynect. You know, the plans that all states were supposed to create under Obamacare? Kentucky's democratic governor created it and it was a huge success. Unfortunately, very few people actually knew that Kentucky's health care plan was dependent on the hated Obamacare. They were lied to and they were blinded by the hateful rhetoric about it and Obama. They live in the conservative media bubble and they don't believe anything other than what they hear from Fox News and the like. It's unfortunate but it's their own fault.

Ferg said...

Are there ANY reports anywhere where a journalist asks the question directly "Why did you vote for the person who will take away the health insurance of you and your loved ones?" It seems like most questioners always sort of beat around the bush and expect the interviewee to figure out what they are getting at. These people are dumb or brainwashed or both. They need to be pushed into a corner and asked WHY you did this to your own children.

Ok said...

Look, you know as well as I do that this will all be blamed on Obama, Hillary and libruls. I guess people really don't appreciate things that are free. You can lead an ass to freedom but you can't make it think.

e.a.f. said...

You can not save those who will not be saved. These people voted for Trump knowing his position on the ACA, so they can't be that interested in their personal health or they are plain stupid.

its the adults who voted but it will be the children who suffer the most and they didn't get to vote. when people in this area realize their lives will not improve and Trump lied to them, things ought to get interesting.'

We in Canada have a good medical system and we're all covered, province by province. We spend less on our health care system and more people are covered for more things.

Medicare is so expensive in the U.S.A. BECAUSE so many people don't have any medical care until they turn 65 and then they go to doctors after having problems for 40 years, problems which would have been less costly if they had been dealt with 35 years ago.

Unknown said...

It's hard for me to feel sorry for these people, except for the fact that the dumbing down of the American society is a real thing and they are certainly the victims. Anti-intellectualism is now mainstreamed in the media and in the political arena. Not only has critical thinking skills been targeted, even practical knowledge is suppressed. How would the right wing otherwise continue to dominate in states like Kentucky and my home state of Ohio? The film Idiocracy may very well be a prescient look into our future.

dave said...

the democratic party--let's be real, the ONLY opposition that can take on the republican party has done a poor job of explaining simple problems. this makes sense--the dems are trying to deal with core values, religion, race hatred, authoritarianism. values so deep that in one month in the sixties all the dixie-crats turned republican, a tectonic shift! the deplorables, the cynics and yes the irrational followers of confused but oddly consistent prejudice are lined up to blindly march to the orders of their masters...just as they've been trained.

they learned these things on their daddy's knee, at the same time they learned language--it's that deep. the thought experiment is how hard is it to learn a new language as an adult? how hard it would be to forget english?

Kathleen said...

I have not one iota of sympathy for them. If their racism and hatred drive them to vote out their health care, screw them. It has nothing to do with intelligence. It has to do with choosing hatred. That's a "moral" choice.

@Becky I live about 5 minutes from Northern Kentucky and I can attest to their hatred for Obama. And these are the entitled middle/upper middle classes who espouse it.

A bit OT, but I'm so sick of "Democrats can't talk to Rustbelt White Working Class. Obama bailed out the auto industry for fuck sakes. He saved jobs in Ohio and Michigan. Rethuglicans opposed the bailout.

@Nick Maximovich: Idiocracy is here now.

Anonymous said...

Two suggestions:

1) There are no Democratic/leftish voices in many of these areas (

2) We can cut into these massive gains–which at the margins can help–by not completely ignoring rural issues ( Note that I didn't say place them front-and-center, just not ignoring them, especially downballot.


Unknown said...

Elsewhere under a different alias I have long written that, despite the successes of the ACA, our country is heading toward a health care crisis and we are in no way ready for it: not as individuals, families, communities, states or a nation; not mentally, emotionally, spiritually, physically, financially, corporate-wise, time-management-wise, any-wise.

It's now here. And it'll probably last until most of the baby boomers die off.

I hope this empowers you.

Fiddlin Bill said...

There is a long term strategy at work which must be taken into account re the rural vote. Small states get majority power because of constitutional features. The best simple example is the Senate, but it's there in many ways. If the Republicans can make voting about white voters versus non-white voters, plus the ever-present "pro-life" voters, they can likely maintain a political mandate and majorities in the Congress. Clinton won the popular vote. This is a very significant fact that cannot be ignored. It reflects the constitutional problem we have.

Unknown said...

"worried to death" Uh, yeah. That will be the outcome. I'll be curious if the red Appalachian stronghold will ever figure out that they are being hustled. They'll have to decide between a better life or their ingrained racism. I've already placed my bet.

Also amusing, Gooper governors NEVER mention the reasonable alternative. Raise taxes.

Ferg said...

If Coke lost its market share by several percentage points in this many areas of the country, they would spend whatever amount of money it took to answer the question of why people stopped drinking Coke.

Its too bad some of that Wall Street money couldn't have been spent hiring a few local lefties to go around asking people "Why do you want to eliminate your own source of healthcare?" With enough information we could form a messaging strategy. Whatever it is we are doing now is a disaster.

Again, these stories never ask the subjects directly why they are against their own healthcare. Instead they hop to some sort of social worker or medical provider who says something about how sad it is that people will go without healthcare. That doesn't give us any information we need for the next round of messaging battles.

bowtiejack said...

This is probably the place to recall one of my favorite Mark Twain quotes:

"When the end of the world comes, I want to be in Kentucky, because everything there happens 20 years after it happens anywhere else."

So, yeah, there's no hope.

bowtiejack said...

In other news:

I live in New York City and fortunately do not have to deal with driving or commuting.
However, something like the Lincoln Tunnel during Friday rush hour, connecting New York and New Jersey, is a nightmare you would not wish on anyone, believe me.
So Der Trumpenator, in his aerie high atop Castle Trump on 5th Avenue, decided Friday afternoon that he wanted to go to his New Jersey golf course. And they CLOSED the Lincoln Tunnel for an hour, during rush hour Friday, to let him through.

Guys, I think this is what we can look forward to - governance by whim, sort of like Caligula without the toga.

Robt said...

As the GOP railed in Obamacare repeal and legislative undermining from start to finish.
"Repeal and replace was always repeal. Oh sure, when really pressed, the media allowed the "it doesn't work" mantra to be espoused so very loudly. Never did the pressure to improve and build build on it received even the (both sider) time of day.
Replace always meant "nothing". How about selling across state lines? Yeah, GOP state rights ideology really makes this possible. Of course the Health Savings Accounts that cash strapped folks on diminished wages could ever save enough for a catastrophic illness let alone mild dental care.

I call attention to a very under reported conservative foundation. One that was often raised within GOP town halls and rallies.
"LET THEM DIE" The right's christian conservative economic agenda.
Because, they were fed that the ACA was taking their money and giving it to black and brown chatel. Never considering the "other folks that ACA covered.
They use the race card against it instead of the plain conservative belief of just letting them die.

Trump will have the Greatest inauguration. Try to imagine his speeches. Who will write them?
Climate change may reduce the snowfall in places but I am pretty sure, Bannon, Sessions, and Flinn while inspire the greatest white Christmas you haven't seen since before the Civil War..

June Butler said...

I have talked to people who loudly defend Medicare but who do not know it is a federal program. I have talked to people who have health insurance for the first time through Obamacare, but who do not know that simple fact, because their insurance company has a different name. How do we convince people at that level of ignorance not to vote against their own interests? I don't know. I've tried and been shouted down time after time in my very red state in the South, and I've given up.

DonP said...

This brings up a question I've been pondering since the election; how do we,as DFH's, say to people "Of course this happened, how could you NOT KNOW this was going to happen?!!" when then Trump Presidency crumbles apart. I, personally, can't do it without coming off as a monumental ass.

R White said...

I used to think that if we had a couple of brave, altruistic souls in DC working with the FCC who gave a damn about this country's future and reinstituted the Fairness Doctrine, that maybe our fourth estate would be forced to begin to re-educate the masses, especially those here in the Red States. This election and its horrible results eradicated any hope even if such afore mentioned events were to take place. After 40 years of fear-based BS propaganda, there is a segment of the population that is gone and not coming back to the reality that a majority of us live in. And to make things worse, the media having created the ratings winning frankenstein we all know as our president-elect, are now trying to fuel the flames of our divide even more so by reporting every little squabble in attempts to start a race war, but do so in a both siderist fashion.

On another note, Rude Pundit just late last week said that he is taking a break or possibly quitting altogether. I get it and understand how tiresome it can be to run a blog of current events that seem as if we are on constant repeat every 8 years to the same horrific economic and social outcomes.

With that being said, thanks DG and BlueGal for being a light of inspiration and hope in such dark times.

John said...

My first take, the night of the election, was, "Oh jeeze, those poor people have no idea what they've done to themselves." Later I realized that was my educated elitist brain talking, and in the real world, they're on their own now. If the national government leaves the healthcare of its citizens in some states to the vicissitudes, poorest of them will be hurting soon. I have no idea how to fix this. There will be NO do-over of the election, I'm afraid.

Jimbo said...

Nearly 400 years of genocide, slavery and religious intolerance has fashioned the culture of rural white America. The Southern Baptist Convention, probably the largest, single religion of the rural South and Bible belt was created in 1845, specifically to defend the institution of slavery (breaking off from Northern Baptists). So bigotry and ignorance is absolutely fundamental to the part of the country the Constitution was expressly designed to protect.

Beyond secession and the creation of the independent republics of East Coastia and West Coastia, it's kind of hard to imagine a future not dominated by essentially extreme right wing policies and a steady decline in the socio-economic progress in the country. Until humanity is wiped out by climate change.

And the corporate media will be no help at all even if the Fairness Doctrine was (improbably) reinstituted.

Robt said...

Don P
" I, personally, can't do it without coming off as a monumental ass."

No worries. You are already an "ASS" to them. You voted for HRC. Against their tax cuts. The SCOTUS seat to protect their constitutional right to be baptised strapped with their AR-15.

I am sure they will be an ass by telling you Obama did it. maybe it is that lying liberal media you worship. But they will and are nasty about it already.

Engage or not to engage. That is the logical question.

Tanbark said...

I have to point out a few things:

In his campaigning, Obama promised us a single-payer form of medical care.

He came in with a 79 seat majority in the House, and a 19 seat majority in the Senate. Both were historic majorities. He had them for two years. But all the republicans had to do was whisper "filibuster!" and he quickly caved, and started "reaching out" to them.

If he had run a good, Canadian-style bill up to the hill, and had kept bringing it up, the repubs would have folded like a house of cards, and the door would have been open for all kinds of good, progressive things to happen.
Surely other people remember his insults and taunting of progressives, as our being too extreme and demanding?

I think his biggest "legacy" will be doing rehab on a republican party that was in complete disarray…and unfortunately, it's in no danger of going away.

driftglass said...

Why some Liberals feel compelled to regurgitate debunked Republican talking points is a mystery to me...

The Myth of the Filibuster-Proof Democratic Senate


Republicans have magically, mystically turned 72 days into two full years.

We’ve heard it over and over and over again. Mitch McConnell has gleefully used it as a cudgel. Congressional Republicans typically can’t wait to get their mugs on camera to tell America just how inept Congressional Democrats are in order to aid their case that they should be put back in power. After all, Democrats couldn’t get anything done even with a 60 vote, filibuster-proof majority in the United States Senate during the first two years of the Obama administration. Democrats had almost complete control of the Congress to go with the newly inaugurated Democrat to take up residence at 1600 Pennsylvania Avenue, and they couldn’t manage to address the major issues of the day.

Democrats are just plain horrible at their jobs. To hear the Republicans tell it, absolutely nothing got done between January 2009 and the 2010 midterm elections. And they blame the Democrats, because after all, the Democrats were in control.

Don’t believe it.

It sounds good and it surely gets the far right wing base riled up. But it has very little basis in reality. That hasn’t stopped Republicans and their official media apparatus, Fox News, from repeating the nonsense...

Tanbark said...

I'm not sure it was quite filibuster proof. Not in reality. I think he needed Lieberman, and that, of course, was after Lieberman supported McCain in the election, so, no help there.

but the point is, that he had one hell of a mandate for real change, when he doubled John McCain's electoral vote.
While I'm at it, there ought to be a Nobel prize for the best photoshoppe work, and if there were, Driftglass would need a trophy room, for the wondrous things he's given us. :o) b

My favorite was the one of Obama and Rahm Emanuel obligingly slathering unguents on a naked Joe Lieberman, after the democrats had rewarded Lieberman for his perfidy, by letting him keep his committee seat.

It was sweet, wicked, stuff! :o)

Ed Cooper said...

Well, OK, but after Jan 20, he can fly to the golf course on Marine One.